What is the normal reference range for iron levels in the blood?

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Normal Reference Ranges for Iron Levels in Blood

The normal reference range for plasma iron is 50-175 μg/dL (micrograms per deciliter), though laboratory-specific reference ranges should be used as the definitive standard due to methodological variations between testing facilities. 1

Key Iron Status Markers and Their Reference Ranges

Iron status is assessed using multiple parameters, as a single measurement rarely provides complete information about iron stores. The most important markers include:

Serum/Plasma Iron

  • Reference range: 50-175 μg/dL 1
  • Direct measurement of circulating iron
  • Highly variable throughout the day
  • Significantly affected by inflammation

Ferritin

  • Reference ranges:
    • Men: 20-250 μg/L
    • Women: 20-200 μg/L 1
    • Alternative ranges: Men: 24-336 μg/L; Women: 11-307 μg/L 1

Transferrin Saturation

  • Reference range: 20-50% 1
  • Calculated as: (Serum iron / Transferrin) × 71.24
  • Values <20% suggest iron deficiency

Total Iron Binding Capacity (TIBC)

  • Reference range: 250-370 μg/dL (45-66 μmol/L) 1
  • Reflects the capacity of transferrin to bind iron
  • Increases in iron deficiency

Transferrin

  • Reference range: 200-400 mg/dL 1
  • Iron transport protein
  • Levels increase proportionally to iron needs

Hemoglobin (for context)

  • Men: 13.5-17.5 g/dL
  • Women: 12.0-15.5 g/dL 1

Mean Cell Volume (MCV)

  • Reference range: 80-100 fL 1
  • Reduced in iron deficiency (microcytosis)

Important Considerations When Interpreting Iron Studies

  1. Laboratory Variability: Due to methodological differences between laboratories, the reference ranges provided by the specific testing laboratory should always be used 1.

  2. Influence of Inflammation: Most iron markers (especially ferritin) are affected by inflammation, which can mask true iron deficiency 1.

  3. Ferritin as a Key Marker:

    • Serum ferritin is the most specific test for iron deficiency in the absence of inflammation 1
    • A level <15 μg/L is highly specific for iron deficiency (specificity 0.99) 1
    • In the presence of inflammation, a ferritin cutoff of 45-50 μg/L provides better sensitivity while maintaining good specificity 1
  4. Diagnostic Accuracy: When multiple markers are abnormal, the diagnostic certainty increases. For example, low ferritin plus low transferrin saturation strongly suggests iron deficiency 1.

  5. Gold Standard: When results are unclear, bone marrow iron staining remains the definitive test for diagnosing iron deficiency 1.

Clinical Implications

Iron deficiency is the most common nutritional deficiency worldwide, affecting approximately 2 billion people 2. Early detection through proper interpretation of iron studies can prevent progression to iron deficiency anemia, which affects approximately 10 million people in the US alone 2.

For patients with suspected iron deficiency, a comprehensive iron panel including ferritin, transferrin saturation, and serum iron provides the most accurate assessment of iron status, especially when inflammation may be present.

Remember that normal reference ranges may vary slightly between different laboratories and testing methods, so always refer to the specific ranges provided by your laboratory.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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